Individual
MR. SAMUEL C LOFTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4804 LEAVITT RD, LORAIN, OH 44053-2139
(440) 324-5588
(440) 324-2075
Mailing address
4804 LEAVITT RD, LORAIN, OH 44053-2139
(440) 324-5588
(440) 324-2075
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1059451
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000324024
ANTHEM
OH
01
—
128429100
FEDERAL WORKERS COMP
OH
01
—
P00050528
RAILROAD MEDICARE
OH
Enumeration date
06/10/2005
Last updated
01/28/2014
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